Indian pediatrics最新文献

{"title":"Prevention of VAP Using Hypertonic Saline Nebulization in NICU: A More Nuanced Perspective is Required.","authors":"Shubhangi Chaturvedi, Manish Kumar","doi":"10.1007/s13312-025-00114-5","DOIUrl":"https://doi.org/10.1007/s13312-025-00114-5","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Ventilation Strategies in Neonates.","authors":"Jogender Kumar, Praveen Kumar, Vineet Bhandari","doi":"10.1007/s13312-025-00094-6","DOIUrl":"10.1007/s13312-025-00094-6","url":null,"abstract":"<p><p>We provide evidence-based recommendations and clinical guidance on strategies for invasive mechanical ventilation in neonates until successful extubation in the neonatal intensive care unit. A systematic search of the PubMed, Embase, and CENTRAL databases was performed to identify relevant published literature from the past five years. A critical review of the current literature was conducted to provide context-specific recommendations. We discuss the various modes of invasive mechanical ventilation in neonates, with specific recommendations for neonates with persistent pulmonary hypertension, congenital heart disease, congenital diaphragmatic hernia, pneumonia, meconium aspiration syndrome, air leak syndromes, evolving and established bronchopulmonary dysplasia, apnea, and very preterm infants with respiratory distress. Practical guidance for the initiation, titration, and weaning of volume-targeted ventilation is also provided. Synchronized patient-triggered modes (synchronized intermittent mandatory ventilation + pressure support ventilation/assist control ventilation) and volume-target/guarantee modes are the preferred modes of invasive mechanical ventilation in neonates with respiratory distress.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of Hepatitis A in Non-vaccinated Adolescents Aged 9 to 12 Years in New Delhi, India: A Cross-Sectional Study.","authors":"Anurag Agarwal, Shweta Sajlan, Rohit Chawla, Surendra Bahadur Mathur","doi":"10.1007/s13312-025-00090-w","DOIUrl":"https://doi.org/10.1007/s13312-025-00090-w","url":null,"abstract":"<p><strong>Objective: </strong>To determine the seroprevalence of hepatitis A among non-vaccinated adolescents aged 9-12 years and to ascertain the sociodemographic factors associated with seropositivity.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among non-vaccinated adolescents aged 9-12 years from urban and semi-urban settings in New Delhi. Sera were analyzed using competitive ELISA to detect IgG antibodies against hepatitis A. Sociodemographic data were collected using a structured pro forma.</p><p><strong>Results: </strong>Of the 94 participants, 85 (90.4%) were seropositive for hepatitis A. Seropositivity was significantly associated with low socioeconomic status, lower parental education levels, lower parental occupation status, and low monthly household income.</p><p><strong>Conclusions: </strong>Despite improved sanitation, lower socioeconomic groups remain highly endemic for hepatitis A. Catch-up vaccination may have limited utility in adolescents aged 10 years or older from these backgrounds. Targeted public health strategies and further evaluation of vaccination policies in specific populations are needed.</p><p><strong>Trial registration: </strong>Clinical Trials Registry-India No. CTRI/2022/10/046790.Obtained.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Antiretroviral Therapy and Vitamin E Supplementation on Total Antioxidant Capacity in Children Living with HIV.","authors":"K Jai Kumar, Pooja Dewan, Rajarshi Kar, Edelbert Anthonio Almeida, Deepika Harit, Mrinalini Kotru, Mukesh Yadav","doi":"10.1007/s13312-025-00111-8","DOIUrl":"https://doi.org/10.1007/s13312-025-00111-8","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the total antioxidant capacity (TAC) in children living with HIV (CLHIV) and to evaluate the effect of antiretroviral therapy (ART) and vitamin E supplementation on TAC.</p><p><strong>Methods: </strong>The study included CLHIV on ART ≥ 2 years, ART-naïve CLHIV and healthy controls. CLHIV on ART ≥ 2 years received vitamin E supplements in addition to combination ART for three months duration. TAC levels, α-tocopherol levels, hemogram, red blood cell indices, viral load and CD4 counts were estimated at baseline and after three months of ART.</p><p><strong>Results: </strong>A total of 25 children were included per group. The median (IQR) TAC levels (mM Trolox Equiv) were significantly lower in CLHIV ART for ≥ 2 years [6.32 (8.7, 13.28)], compared to controls [11.89 (8.15, 14.38)] and ART-naïve CLHIV [12.69 (7.61, 16.78)]. TAC levels increased after 3 months of starting ART [15.57 (9.90, 17.49); P = 0.178]. α-tocopherol levels (µmol/L) were significantly different among the three groups, viz controls [72 (28.86, 80)], ART-naïve CLHIV [40.24 (30.36, 71.59)] and CLHIV on ART ≥ 2 years [16.77 (13.15, 20.21)]. Three months of vitamin E supplementation, failed to produce a significant increase in TAC levels [10.4 (7.28, 14.92)] while the red cell indices and CD4 counts improved significantly with a marginal reduction in HIV viral load.</p><p><strong>Conclusion: </strong>Prolonged ART reduced antioxidant capacity. Three months of vitamin E supplementation produced marginal increase in TAC levels.</p><p><strong>Trial registry: </strong>CTRI/2022/12/047960 [Registered on: 08/12/2022] Trial Registered Prospectively.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder's Perspectives on the Barriers and Facilitators of Childhood Cancer Care in India.","authors":"Anita Nath, Prashant Mathur, Kondalli Lakshminarayana Sudarshan, Ramandeep Arora, Rachna Seth, Sanjiv Kumar, Girish Chinnaswamy, Atul Budukh, Varinder Singh, T Priya Kumari, Raja Paramjeet Singh Banipal, Vijay Kumar Bodal, A R Arun Kumar, C R Vijay, T Avinash, C Ramesh, Sadashivudu Gundeti, Shikha Malik, Narendra Kumar Chaudhary, Gautam Majumdar, Deepshikha Das, Nita Radhakrishnan, V Surya Rao, Manoj Rawal, Jeremy L Pautu, Deepak Sundriyal, Munlima Hazarika, Caleb Harris, Sunil Natha Jondhale, Vinotsole Khamo, Arshad Manzoor Najmi, Puneet Pareek, Ratan Konjengbam, Saroj Kumar Das Majumdar, Shashank Pandya, Anand Shah, S B Singh, Venkatraman Radhakrishnan, R Swaminathan, Chandra Mohan Kumar, Pritanjali Singh, Lokesh Tiwari, Syamsundar Mandal, Sopai Tawsik, Awadhesh Kumar Pandey, K Gunaseelan, Tseten W Bhutia","doi":"10.1007/s13312-025-00098-2","DOIUrl":"https://doi.org/10.1007/s13312-025-00098-2","url":null,"abstract":"<p><strong>Objective: </strong>To explore the stakeholders' perspectives on barriers and facilitators influencing childhood cancer care delivery in India.</p><p><strong>Methods: </strong>A nationwide survey was conducted across 26 states and 4 Union Territories, involving childhood cancer physicians from tertiary and secondary hospitals, state nodal officers (SNOs) for the National Programme for Control of Non-Communicable Diseases (NP-NCD), and representatives from Civil Society Organizations (CSOs) and Non-Governmental Organizations (NGOs). A hub-and-spoke sampling model was employed, with designated tertiary hospitals coordinating data collection from secondary hospitals. An online survey tool assessed perceived challenges and facilitators in childhood cancer care. Data collection occurred from July to September 2021, and descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Responses were received from 137 tertiary hospitals (100%), 92 secondary hospitals (91%), 16 SNOs (53.3%), and 9 CSO/NGO representatives (23.1%). Key barriers to diagnosis and treatment included shortage of human resources, beds, and equipment, along with advanced-stage presentation and inadequate back-referrals from tertiary to secondary hospitals. Treatment abandonment and denial were highlighted as major concerns. SNOs and CSOs identified financial constraints, limited insurance coverage, and reliance on traditional healers as additional challenges. Facilitators included strengthening referral networks, expanding diagnostic capabilities, ensuring free treatment and medications, and improving infrastructure and workforce capacity.</p><p><strong>Conclusion: </strong>Resource constraints, late-stage presentation, treatment abandonment, and financial challenges are the significant barriers to childhood cancer care in India. Addressing these through improved referral systems, expanded diagnostic services, financial support mechanisms, and policy-level interventions are needed to enhance childhood cancer care outcomes and quality of life.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine as an Adjunct to Follow-Up of Low-Risk Neonates: A Prospective Cohort Study.","authors":"Remya Rajkumar, Nabagata Roy, Femitha Pournami, Ajai Kumar Prithvi, Naveen Jain","doi":"10.1007/s13312-025-00053-1","DOIUrl":"10.1007/s13312-025-00053-1","url":null,"abstract":"<p><strong>Background: </strong>Synchronous video teleconsultations are being increasingly used in various fields of medical care. Its feasibility, safety and advantages have been demonstrated in neonatal office practice in our unit.</p><p><strong>Methods: </strong>This prospective study was conducted to measure proportion of parents of low-risk neonates who utliized teleconsultations for postnatal follow-up.</p><p><strong>Results: </strong>Of 844 eligible families, 22.3% used the service. Lactation queries (57.1%) about feeding schedules and perceived less milk related excess cry predominated. Enquiries related to skincare (36.5%) and sleep-wake cycle (30.1%) were common. Only 3.8% were advised to report to the hospital for physical assesssment.</p><p><strong>Conclusions: </strong>The number of families who engaged in the teleconsultations with the neonatologist were less than anticipated. However among those who did, majority of the concerns could be resolved without the need for physical hospital visits.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"437-439"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Paroxysmal Torticollis as a Presenting Feature of Stress-Induced Childhood-Onset Neurodegeneration with Variable Ataxia and Seizures (CONDSIAS).","authors":"Anita Modage, Virendra Gaonkar, Myla Isha Pereira","doi":"10.1007/s13312-025-00083-9","DOIUrl":"10.1007/s13312-025-00083-9","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"468-469"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Proton Pump Inhibitor as Stress Ulcer Prophylaxis in Sick Children: A Randomized Controlled Trial.","authors":"Ananya Kavilapurapu, A V Lalitha, Santu Ghosh","doi":"10.1007/s13312-025-00035-3","DOIUrl":"10.1007/s13312-025-00035-3","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of intravenous pantoprazole as a stress ulcer prophylaxis in sick children to prevent gastrointestinal (GI) bleeding.</p><p><strong>Methods: </strong>A randomized controlled trial included children aged one-month to 18 years requiring intensive care. Participants were randomly assigned to receive intravenous pantoprazole or a placebo (normal saline) daily. The primary outcome was the incidence of GI bleeding (clinically significant or overt). Secondary outcomes were the median time of onset of GI bleeding, incidence of ventilator-associated pneumonia (VAP), duration of hospitalization, organ dysfunction scores, and all-cause mortality.</p><p><strong>Results: </strong>A total of 151 and 150 children were allocated to group A (pantoprazole) and group B (placebo), respectively. No significant difference was observed in the incidence of GI bleeding between the groups (group A: 21/151 vs group B: 19/150 [RR (95% CI) 1.03 (0.18, 5.82), P = 0.985]. Comparable results were observed for clinically significant GI bleeding (1.3% vs 0.6%; RR (95% CI) 0.54 (0.21, 1.28); P = 0.653 and overt GI bleeding [12.6% vs 12%; RR (95% CI) 0.98 (0.39, 2.23); P value = 0.313]. On multivariate analysis, there was a reduced incidence of GI bleeding in children with coagulopathy in pantoprazole group (n = 29) as compared to placebo (n = 25) [RR (95%CI) 0.52 (0.32, 0.87); P = 0.022].</p><p><strong>Conclusion: </strong>Among critically ill children, pantoprazole prophylaxis did not reduce the incidence of gastrointestinal bleeding, although, a notable decrease in gastrointestinal bleeding was observed in children with coagulopathy.</p><p><strong>Trials registry: </strong>Clinical Trials Registry of India, Ref no: CTRI/2021/08/035785, Date of registration:18th August 2021.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"407-413"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 1-59 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mohammad Tanashat, AlMothana Manasrah, Omar Abdullah Bataineh, Ahmad Abdelrazek, Mohamed Abouzid","doi":"10.1007/s13312-025-00081-x","DOIUrl":"10.1007/s13312-025-00081-x","url":null,"abstract":"<p><strong>Objective: </strong>Continuous positive airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ventilators are often unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effective and less invasive alternative to CPAP, however, its efficacy has not been assessed for children with pneumonia until recently. This meta-analysis aims to compare the effectiveness of bCPAP with low-flow oxygen for treating severe pneumonia and hypoxemia in children.</p><p><strong>Methods: </strong>PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to identify eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager software. P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Three studies with 2030 patients were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (- 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ventilation [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048].</p><p><strong>Conclusion: </strong>bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ventilation decreases.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"440-450"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Type Atypical Rabies Encephalitis: A Case Report.","authors":"Lukshay Bansal, Shibani Mehra","doi":"10.1007/s13312-025-00043-3","DOIUrl":"10.1007/s13312-025-00043-3","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"464-467"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}